Purpose To date, the relationship between footstrike pattern and performance, as well as with injury incidence in endurance running remains unclear. For these reasons, it is currently not recommended to modify footstrike pattern in an uninjured long-distance runner. The purpose of this study was to analyse whether athletic coaches apply these current scientific recommendations with their endurance runners on the field. Methods A Delphi method study was used to develop an online survey that was administered to French-speaking athletic coaches in Belgium. The survey comprised three sections: 1) coaches` profile, 2) coaches` perception of footstrike patterns, 3) practices pertaining to footstrike patterns. Results One hundred and fourteen respondents completed the entire questionnaire. Ninety-six (84%) athletic coaches reported modifying the footstrike pattern of their endurance runners. They reported that they modify their runners` rearfoot and forefoot strike more often than a midfoot strike (P < 0.0001) to prevent injury (83%) and to improve performance (66%). According to them, midfoot strike is considered as the best landing pattern for endurance performance (47%) and injury prevention (36%) whereas rearfoot strike is considered as the worst (respectively, 50% and 52%). Summary and conclusion This study highlights the disparities between scientific recommendations and athletic coaches` field practices for modifying footstrike patterns in endurance runners. Contrary to current scientific literature recommendations, a large proportion of coaches modify the natural footstrike pattern of their endurance runners towards a midfoot strike pattern to improve performance and prevent injury.
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